Feedback Survey Form

This form is designed to monitor your response to the members we’ve introduced to you. The purpose is to judge our success – yours and The Ideal Match’s® – not to criticize the individual. Written feed back is a critical part of your membership responsibility.

Please fill out this form completely and return it as soon as possible to enable us to fine tune your matching. We appreciate your cooperation so that we can better serve you.

Your Information

First Name :

(Response Required)

Last Name :

(Response Required)

Phone :

(Response Required)

Email :

(Response Required)

Your Referrals Information

First Name :

(Response Required)

Last Name (if known) :

Was contact made? :

YesNo(Response Required)

If not, Why?

Did you meet? If not, Why?

YesNo(Response Required)

If not, Why?

Tell us your thoughts on this referral. Please be specific to include details such as but not limited to physical appearance, personality, and likes-dislikes etc.